Purpose: :
To better understand the distinguishing features of ocular toxoplasmosis(OT) following two different modes of Toxoplasma gondii infection,e.g. congenital versus acquired, we evaluated the interval betweendocumented systemic toxoplasmic infection to the first detectionof OT in a subset of Brazilian patients.

Methods: :
This is a retrospective review of charts of 2168 patients evaluatedat the Uveitis Section of the Hospital São Geraldo atthe Universidade Federal de Minas Gerais, Brazil, from April1982 to October 2007. After a thorough evaluation, 1552 patientswere given the diagnosis of presumed OT and of these, 47 wereconsidered to have acquired toxoplasmic infection by demonstratingpositive anti-T. gondii IgG and IgM antibodies. The followingdata was collected: clinical presentation of systemic toxoplasmosisand interval since systemic disease to the first detection ofOT. Patients’ age and gender as well as clinical presentationof the ocular disease at the time of first detection were evaluated.

Results: :
Patients with documented primary toxoplasmic infection presentedwith a range of findings at initial diagnosis: lymphadenopathy(n=21), unspecific (fever, myalgia, adynamia, headache, hepatosplenomegaly;n=6), pneumonia (n=1), ocular symptoms only (OT; n=8), and indeterminate(n=7). The remaining four patients seroconverted during pregnancyand were all followed subsequently at the same center by thefirst author. The interval between the first findings of acquiredsystemic infection to the detection of OT varied: 0 (n=8), 1-90days(n=20), 91days-36months (n=9), >36months (n=10). The mean(SD) age of the 47 patients (male, 27; female, 20) at the timeof the detection of OT was 34.26±15.69 (range, 6 to 67years). OT presented as retinochoroiditis in 44 patients, papillitisin 1 patient, and anterior granulomatous uveitis in 1. In theremaining patient, a 12-years-old child, a drop of visual acuityassociated with an epiretinal membrane was the only ocular featuresidentified at the time of systemic disease.

Conclusions: :
In our series of patients with acquired OT, we demonstrate thatOT can develop up to 23 years after the initial systemic infection.